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Physical activity among adult survivors of childhood lower-extremity sarcoma

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Abstract

Introduction

Adult survivors of childhood lower-extremity sarcoma are largely physically inactive, a behavior which potentially compounds their health burden. Altering this behavior requires understanding those factors that contribute to their physical inactivity. Therefore, this investigation sought to identify factors associated with inactivity in this subpopulation of cancer survivors.

Methods

Demographic, personal, treatment, and physical activity information from adult survivors of childhood lower-extremity sarcomas was obtained from the Childhood Cancer Survivor Study (CCSS) cohort. Generalized linear models were used to identify variables that best identified those individuals who were physically inactive.

Results

Only 41% of survivors met Center for Disease Control (CDC) activity guidelines. Survivors were 1.20 (95% confidence intervals (CI) 1.11–1.30) more likely compared to CCSS sibling cohort and 1.12 (95% CI 1.10–1.15) times more likely than the general population to fail to meet CDC guidelines. Significant predictors of physical inactivity included female sex, hemipelvectomy surgery, and platinum and vinca alkaloid chemotherapy.

Conclusions

The primary findings of this study are that survivors of childhood onset lower-extremity sarcoma are (1) highly likely to be physically inactive and (2) less likely than their siblings or the general population to regularly exercise. This study has identified treatment-related risk factors associated with inactivity that will help health and wellness practitioners develop successful exercise interventions to help these survivors achieve recommended levels of physical activity for health.

Implications for cancer survivors

These results suggest that physical activity interventions for adult survivors of childhood lower-extremity sarcomas should be sex specific and responsive to unique physical late effects experienced by these survivors.

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References

  1. Heare T, Hensley MA, Dell'Orfano S. Bone tumors: osteosarcoma and Ewing's sarcoma. Curr Opin Pediatr. 2009;21:365–72.

    Article  PubMed  Google Scholar 

  2. Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N, et al. SEER Cancer Statistics Review, 1975–2006, based on November 2008 SEER data submission. Bethesda, MD: National Cancer Institute http://seer.cancer.gov/csr/1975_2006/ (2009). Accessed 17 January 2011

  3. Hosalkar HS, Dormans JP. Limb sparing surgery for pediatric musculoskeletal tumors. Pediatr Blood Cancer. 2004;42:295–310.

    Article  PubMed  Google Scholar 

  4. Marina N, Gebhardt M, Teot L, Gorlick R. Biology and therapeutic advances for pediatric osteosarcoma. Oncologist. 2004;9:422–41.

    Article  PubMed  Google Scholar 

  5. Carty CP, Dickinson IC, Watts MC, Crawford RW, Steadman P. Impairment and disability following limb salvage procedures for bone sarcoma. Knee. 2009;16:405–8.

    Article  PubMed  Google Scholar 

  6. Kadan-Lottick NS, Dinu I, Wasilewski-Masker K, Kaste S, Meacham LR, Mahajan A, et al. Osteonecrosis in adult survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2008;26:3038–45.

    Article  PubMed  Google Scholar 

  7. Scully RE, Lipshultz SE. Anthracycline cardiotoxicity in long-term survivors of childhood cancer. Cardiovasc Toxicol. 2007;7:122–8.

    Article  PubMed  CAS  Google Scholar 

  8. Earl HM, Connolly S, Latoufis C, Eagle K, Ash CM, Fowler C, et al. Long-term neurotoxicity of chemotherapy in adolescents and young adults treated for bone and soft tissue sarcomas. Sarcoma. 1998;2:97–105.

    Article  PubMed  CAS  Google Scholar 

  9. Kaste SC, Ahn H, Liu T, Liu W, Krasin MJ, Hudson MM, et al. Bone mineral density deficits in pediatric patients treated for sarcoma. Pediatr Blood Cancer. 2008;50:1032–8.

    Article  PubMed  Google Scholar 

  10. Lipshultz SE, Alvarez JA, Scully RE. Anthracycline associated cardiotoxicity in survivors of childhood cancer. Heart. 2008;94:525–33.

    Article  PubMed  CAS  Google Scholar 

  11. Meacham LR, Chow EJ, Ness KK, Kamdar KY, Chen Y, Yasui Y, et al. Cardiovascular risk factors in adult survivors of pediatric cancer—a report from the childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev. 2010;19:170–81.

    Article  PubMed  Google Scholar 

  12. Ness KK, Leisenring WM, Huang S, Hudson MM, Gurney JG, Whelan K, et al. Predictors of inactive lifestyle among adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Cancer. 2009;115:1984–94.

    Article  PubMed  Google Scholar 

  13. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4:87–100.

    Article  PubMed  Google Scholar 

  14. Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Vallance JK, et al. A longitudinal study of exercise barriers in colorectal cancer survivors participating in a randomized controlled trial. Ann Behav Med. 2005;29:147–53.

    Article  PubMed  Google Scholar 

  15. Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol. 2005;23:5814–30.

    Article  PubMed  Google Scholar 

  16. Rogers LQ, Hopkins-Price P, Vicari S, Pamenter R, Courneya KS, Markwell S, et al. A randomized trial to increase physical activity in breast cancer survivors. Med Sci Sports Exerc. 2009;41:935–46.

    Article  PubMed  Google Scholar 

  17. Robison LL, Armstrong GT, Boice JD, Chow EJ, Davies SM, Donaldson SS, et al. The Childhood Cancer Survivor Study: a National Cancer Institute-supported resource for outcome and intervention research. J Clin Oncol. 2009;27:2308–18.

    Article  PubMed  Google Scholar 

  18. The Secretariat/WHO International Association of Cancer Registries. International Classification of Diseases for Oncology. 3 rd Edition (ICD-O-3)th ed. Lyon Cedex, France: World Health Organization; 2000.

    Google Scholar 

  19. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402–7.

    Article  PubMed  CAS  Google Scholar 

  20. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Questionnaire. http://www.cdc.gov/brfss/questionnaires/pdf-ques/2003brfss.pdf (2003). Accessed 14 May 2001

  21. Jones DA, Ainsworth BE, Croft JB, Macera CA, Lloyd EE, Yusuf HR. Moderate leisure-time physical activity: who is meeting the public health recommendations? A national cross-sectional study. Arch Fam Med. 1998;7:285–9.

    Article  PubMed  CAS  Google Scholar 

  22. Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults' participation in physical activity: review and update. Med Sci Sports Exerc. 2002;34:1996–2001.

    Article  PubMed  Google Scholar 

  23. Warms CA, Belza BL, Whitney JD. Correlates of physical activity in adults with mobility limitations. Fam Community Health. 2007;30:S5–16.

    PubMed  Google Scholar 

  24. Osterkamp LK. Current perspective on assessment of human body proportions of relevance to amputees. J Am Diet Assoc. 1995;95:215–8.

    Article  PubMed  CAS  Google Scholar 

  25. Katon W, Richardson L, Russo J, McCarty CA, Rockhill C, McCauley E, et al. Depressive symptoms in adolescence: the association with multiple health risk behaviors. Gen Hosp Psychiatry. 2010;32:233–9.

    Article  PubMed  Google Scholar 

  26. Derogatis LR. Brief Symptom Inventory (BSI) 18, Administration, Scoring, and Procedures Manual. Minneapolis, MN: NCS Pearson, Inc.; 2000.

    Google Scholar 

  27. McCullock C, Searle S. Generalized, linear, and mixed models. Wiley, NY: Wiley; 2001.

    Google Scholar 

  28. Deddens JA, Petersen MR, Lei X, (eds). Estimation of prevalence ratios when PROC GENMOD does not converge. SUGI Proceedings (Paper 270–28) 2003 March 30–April 2; Seattle, Washington.

  29. Egede LE, Poston ME. Racial/ethnic differences in leisure-time physical activity levels among individuals with diabetes. Diabetes Care. 2004;27:2493–4.

    Article  PubMed  Google Scholar 

  30. Jones G, Sinclair L. Multiple health disparities among minority adults with mobility limitations: An application of the ICF framework and codes. Disabil Rehabil. 2008;30:901–15.

    Article  PubMed  Google Scholar 

  31. Gilchrist L, Tanner L, Hooke MC. Measuring chemotherapy-induced peripheral neuropathy in children: development of the Ped-mTNS and pilot study results. Rehab Oncol. 2009;27:7–15.

    Google Scholar 

  32. Ramchandren S, Leonard M, Mody RJ, Donohue JE, Moyer J, Hutchinson R, et al. Peripheral neuropathy in survivors of childhood acute lymphoblastic leukemia. J Peripher Nerv Syst. 2009;14:184–9.

    Article  PubMed  Google Scholar 

  33. Reinders-Messelink HA, Van Weerden TW, Fock JM, Gidding CE, Vingerhoets HM, Schoemaker MM, et al. Mild axonal neuropathy of children during treatment for acute lymphoblastic leukaemia. Eur J Paediatr Neurol. 2000;4:225–33.

    Article  PubMed  CAS  Google Scholar 

  34. Florin TA, Fryer GE, Miyoshi T, Weitzman M, Mertens AC, Hudson MM, et al. Physical inactivity in adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev. 2007;16:1356–63.

    Article  PubMed  Google Scholar 

  35. Wright MJ, Galea V, Barr RD. Proficiency of balance in children and youth who have had acute lymphoblastic leukemia. Phys Ther. 2005;85:782–90.

    PubMed  Google Scholar 

  36. Strath SJ, Bassett Jr DR, Ham SA, Swartz AM. Assessment of physical activity by telephone interview versus objective monitoring. Med Sci Sports Exerc. 2003;35:2112–8.

    Article  PubMed  Google Scholar 

  37. Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion. Physical Activity Guidelines for Americans: Children and Adolescents. http://www.cdc.gov/healthyyouth/physicalactivity/guidelines.htm (2008); updated 2008; cited 2011 January 17

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Acknowledgments

Funding for this study was provided by the National Cancer Institute Grant No. CA 55727 (L.L. Robison, P.I.), with additional support provided to St Jude Children's Research Hospital by the National Cancer Institute Cancer Center Support (CORE) grant CA 21765 and by the American Lebanese Syrian Associated Charities (ALSAC). We would also like to acknowledge the American Physical Therapy Association (APTA) Oncology Section for their assistance and support in the development of the manuscript.

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Authors and Affiliations

  1. Harrison Medical Center, Outpatient Rehabilitation, 2625 Wheaton Way, Suite A, Bremerton, WA, 98310, USA

    Meredith A. Wampler

  2. Adjunct Research Scholar, University of Pennsylvania, Philadelphia, PA, USA

    Mary Lou Galantino

  3. St. Jude Children’s Research Hospital, Memphis, TN, USA

    Sujuan Huang, Melissa M. Hudson, Gregory T. Armstrong, Leslie L. Robison & Kirsten K. Ness

  4. St. Catherine University, Minneapolis, MN, USA

    Laura S. Gilchrist

  5. Penn State Hershey College of Medicine at The Pennsylvania State University, Hershey, PA, USA

    Victoria G. Marchese

  6. University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    G. Stephen Morris & Marilyn Stovall

  7. American Physical Therapy Association, Alexandria, VA, USA

    David A. Scalzitti

  8. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Kevin C. Oeffinger

  9. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Wendy M. Leisenring

  10. Stockton University, Stockton, NJ, USA

    Mary Lou Galantino

  11. Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA

    Laura S. Gilchrist

  12. Lebanon Valley College, Annville, PA, USA

    Victoria G. Marchese

Authors
  1. Meredith A. Wampler
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  2. Mary Lou Galantino
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  14. Kirsten K. Ness
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Corresponding author

Correspondence to Meredith A. Wampler.

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Wampler, M.A., Galantino, M.L., Huang, S. et al. Physical activity among adult survivors of childhood lower-extremity sarcoma. J Cancer Surviv 6, 45–53 (2012). https://doi.org/10.1007/s11764-011-0187-5

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  • DOI: https://doi.org/10.1007/s11764-011-0187-5

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